Aphthous stomatitis treatment. Fast and effective ways to treat aphthous stomatitis. Aphthous stomatitis of granular type

Aphthous stomatitis – inflammatory process, which affects the oral mucosa. The disease can be distinguished by symptoms such as damage to the mucosa and the presence of erosive lesions. In addition, there is discomfort and pain in the gums, which has a bad effect on the quality of life. Stomatitis complicates the process of eating food. You have to give up some foods so as not to further injure the oral mucosa.

Injuries

The oral mucosa can be damaged by eating too hot or hard foods, while using dentures, or by biting the cheek or lip.

Allergic reactions

When consuming certain foods, the human body may respond in the form of allergic reaction. This can lead to the development of aphthous stomatitis. These products include cereals and their derivatives. Do not overconsume foods containing high concentrations of gluten. Often occurred after use:

• chocolate,
• pineapples,
• cheeses,
• citrus fruits,
• some spices.

Genetically determined predisposition

The tendency to develop aphthous stomatitis is often due to hereditary factors. Most often this applies to chronic forms of pathology. According to research by geneticists, if relatives in the family suffered from this disease, the possibility of stomatitis in their children, grandchildren, and so on cannot be ruled out.

Somatic diseases

In case of systemic and chronic malfunctions in the body, local and general immunity. Somatic diseases include:

• blood diseases;
• pathologies associated with immunodeficiency;
• heart and vascular diseases;
• diseases of the respiratory system.

Lack of vitamins and minerals

Vitamins and minerals play an important role in the development of immunity. With their deficiency, the condition of the skin and mucous membranes worsens. Aphthous stomatitis can result from a lack of:

• folic acid,
• ascorbic acid,
• Selena,
• vitamins B,
• zinc,
• gland.

To compensate for the deficiency and restore the balance of vitamins in the body, it is necessary to use special vitamin and mineral complexes. Asepta remains very effective. It contains vitamins such as A, D, C, B. It also contains coral calcium, which serves as a source for remineralizing enamel and stopping lesions chronic inflammation. It is because of this that aphthous stomatitis is formed.

Dental diseases

Plaque, caries and other pathologies of the teeth and gums can lead to the development of stomatitis. Those diseases that involve the formation of a permanent source of infection are very dangerous. You should not delay dental treatment, as this will lead to gum inflammation.

Infectious diseases

When an infection “rages” in the body, it leads to a persistent decrease in immunity. In addition, it can spread and damage other tissues and organs. According to ongoing research, it became known that aphthous stomatitis and chronic forms of pathology occurred against the background of infection with the following microorganisms:

• staphylococci,
• herpes viruses,
• measles virus,
• adenovirus.

Diphtheria and influenza can also affect the development of the disease. So when treating stomatitis, doctors may prescribe antibacterial drugs.

Symptoms

The clinical picture of the pathology is determined taking into account its form.

Fibrinous form

Persistent disturbances of blood microcirculation in the outer layer of the mucous membrane are observed. This contributes to the development of erosion. They are covered with a whitish fibrous coating. Over the course of 1-2 weeks, the rashes heal and are covered with epithelial tissue. Most often, the disease is localized on the mucous membranes of the lips, the lateral surface of the tongue, cheeks, and gums.

Recurrent

Formed no more than 1-3 times a year. Over time, symptoms increase. Most often, recurrent aphthous stomatitis occurs under the influence of a provoking factor. This may include consuming a drink that is too hot, suffering infectious disease, long-term antibacterial therapy, psychological stress.

Aphthous stomatitis of granular type

Formed due to defeat salivary glands. Insufficient functioning of the salivary glands occurs, and aphthae form on the mucous membrane. They concentrate in close proximity to the ducts that secrete saliva. This leads to severe pain in the oral cavity, and the duration of therapy will be 1-3 weeks.

If the acute form of the granular type is not treated, it will become chronic. Exacerbations will occur with prolonged exposure to the cold, with exacerbation of respiratory and other infectious diseases.

The chronic form is the result of the lack of adequate therapy. The reason for this form of pathology is that the damage is initially caused to the ducts of the minor salivary glands. Violates them normal functioning, which is why aphthae are formed along with them. They are quite painful. If you start treatment on time, then after 1-3 weeks all symptoms will disappear. But a common respiratory infection or hypothermia can affect the development of a relapse.

initial stage

For early stage The pathology is characterized by a clinical picture similar to acute respiratory disease. The patient experiences the following symptoms:

• general weakness and malaise,
• loss of appetite and rise in temperature,
• inflammation of the lymph nodes.

Therapy on initial stage comes down to relieving unpleasant symptoms. Assign bed rest and drinking regularly.

External manifestations

Against the background of the general clinical picture patients develop whole line external signs. This should include:

• hyperemia;
• swelling and pain of the mucous membranes of the oral cavity;
• severe itching;
• sleep disturbance.

Painful sensations with stomatitis can be constant or occur against the background of the influence of a specific irritant. This stage can lead to the development of many afts. These ulcerations have a round shape. They appear singly or in small groups. In the area of ​​ulcers, painful sensations are pronounced.

The diameter of aphthae does not exceed 5 mm, but in the absence of adequate therapy they quickly spread through the mucous membrane of the oral cavity to the lips, cheeks, tongue, and palate.

Chronic relapsing

The mechanism of formation of chronic recurrent aphthous stomatitis has not been fully discovered. But there is a clear connection between the state of immunity and the disease. The following reasons can influence the development of chronic aphthous stomatitis:

1. Neuropsychiatric disorders and overexertion;
2. Allergies that occur on certain products nutrition.
3. Trauma to the internal oral region.
4. Regular use of toothpaste, in the production of which sodium lauryl sulfate was used.
5. Hereditary factor. According to ongoing research, every 3rd patient who suffers from chronic recurrent stomatitis runs the risk of getting the disease from their parents.
6. There is a connection between chronic course pathologies and diseases of the blood and gastrointestinal tract.

Necrotic form

This pathology is diagnosed in patients with blood diseases. Canker sores are not painful, but can turn into ulcers. They will leave in 2 weeks or a month.

Scarring form of stomatitis

The disease of the salivary glands continues to progress and affects the connective tissues. Aphthae form not only near the salivary glands, but also on the anterior palatine arches and in the membrane of the pharynx. The diameter of the ulcers reaches 1.5 cm. The healing process proceeds smoothly and will take 3 months. Moreover, scars form at the site of the ulcers.

Deforming form

This form is one of the heaviest. It is accompanied by profound destructive changes occurring in the connective tissues. During therapy, deformation of the palatine arches may be observed.

Treatment in adults

If treatment is not provided on time, then acute aphthous stomatitis will develop into chronic form. The doctor prescribes medications that will relieve pain, discomfort, and reduce the number and frequency of ulcers.

The therapeutic course includes local and general therapy. But only a doctor should be in charge of choosing a medicine. They are prescribed taking into account the symptoms and severity of the disease.

Antiviral tablets

This is what is called a one-day course of treatment for stomatitis. high doses antiviral drugs. For such treatment, the doctor may prescribe:

1. Famciclovir. The dose can be taken once a day; it can be taken once in a dosage of 1500 ml or divided into 2 doses of 750 cm. Take 12 hours between doses. And although the medicine is very effective, it is expensive.
2. Valaciclovir. The duration of therapy will be 1 day. Take 2 times a day, 2000 mg. There is an interval of 12 hours between breaks.
3. Acyclovir. This is outdated antiviral drug, because of this, it is not readily used in medicine.

Local antiviral drugs

This group should include certain types of antiviral gels and antiseptic rinsing solutions. The following drugs remain effective:

1. Miramistin. This is a rinse solution. Use 3-4 times a day. The duration of the procedure is 1 minute. 10-15 minutes after rinsing, you can use Viferon-gel.
2. Viferon gel is a medicine that contains interferons. They have antiviral and immunostimulating effects. Before using the gel, it is necessary to dry the mucous membrane in advance using a dry gauze swab. Apply the drug 3-4 times a day. Duration of use is 5-7 days. The peculiarity of the drug is that it has no age restrictions.

Interferon-based drugs are much more effective than drugs such as Acyclovir and Valacyclovir.

Immunostimulants

The main task assigned to these drugs is to boost immunity and protect against new outbreaks. There are general and local action. The following remedies are effective:

1. Amiksin. This is a tablet drug that is an effective immunostimulant. When using it, you can increase all parts of the immune system. In the first 2 days of illness, take 1 tablet once a day, and then one tablet every other day. The duration of the entire course will be 20 tablets.
2. Imudon. Used to increase local immunity of the oral mucosa. The drug is available in tablet form. Use until completely absorbed. Dosage – 6 tablets per day. Duration of therapy is 20 days.
3. Vitamins. Within 3 months you need to replenish your body with vitamins.

Nutrition correction

It is necessary to adhere to a special diet, according to which it is possible to limit the intake of spicy, salty, and hot foods as much as possible. The fact is that such food irritates the oral mucosa. Also exclude rough foods from your diet. This will prevent the healing ulcers from being re-injured. The diet should contain foods rich in vitamins C and P, which accelerate the healing process of the mucous membrane.

Maintaining immunity

In the treatment of aphthous stomatitis important role dedicated to strengthening the body's defenses. To maintain immunity, a specialist prescribes vitamins. Most often these are complexes that contain vitamin C, group B.

Treatment in children

Often, aphthous stomatitis in children is diagnosed due to sensitivity to food, and specifically to citrus fruits. Sugar, chocolate, wheat and garlic can also affect the development of the disease. You need to pay attention to nutrition. Food should be soft, tender and rich in vitamins and microelements.

To feed your child, use only natural products, which include yoghurts with live bacteria. Vitamin C has a positive effect on tissue healing. It should be taken in a non-acidic form. Most often this is in the form food additives calcium ascorbate. For the treatment of aphthous stomatitis, children are prescribed multivitamins and microelements with zinc. Due to it, the immune system is strengthened and wound healing is accelerated.

Among children's probiotics, Acidophilus or Bifidok can be prescribed. They saturate the microflora of the baby’s oral area beneficial bacteria. They have a positive effect on the healing process.

Traditional methods

Alternative medicine should be used in combination with using medicinal methods prescribed by a doctor.

Topical Recipes

For local treatment of the oral cavity, you can use the following recipes:

1. Take 3% hydrogen peroxide, add it to 100 ml of water, preferably warm. Use the solution to rinse the mouth 3 times a day. This will relieve pain and disinfect oral cavity.
2. Alcohol tincture of propolis. Take 10 ml warm water, add 10 ml of tincture. Use for rinsing 3 times a day. Propolis has an antimicrobial, anti-inflammatory, healing effect.
3. Potato. This is an effective remedy in the treatment of stomatitis. Chop the root vegetable into thin slices, which are applied to the resulting sores. The duration of the manipulation is 20 minutes. You can grind it on a grater and then apply the paste to the affected areas.
4. Aloe. Take Fresh Juice plants and use for rinsing. You can treat the affected areas with it. Carry out the manipulation 4 times a day. If you can’t squeeze out the juice, you can chew the leaves of the plant. Aloe can be replaced with equally effective Kalanchoe.
5. Carrot juice. Squeeze out the juice and dilute in a 1:1 ratio with water. Use as a mouth rinse 3 times a day. Cabbage juice has a similar effect. These vegetables contain antimicrobial components and a lot of vitamins that have a positive effect on the healing process.
6. Garlic is effectively used in the treatment of various types of stomatitis. You need to take a clove of garlic and chop it. Combine the pulp with 40 g of sour cream. Place the mixture in your mouth for 30 minutes. Hold events every day.
7. Blueberry. The berries of this crop are used in the treatment of stomatitis in children and adults. They can be consumed fresh or as a tincture. Take 40 g of raw materials, 200 ml of boiling water. Leave for 40 minutes. Use as a mouth rinse 4 times a day.
8. Egg white. Rinse thoroughly egg. Separate the protein and add 100 ml of water to it. Stir until foam appears, and then use to rinse 5 times a day.
9. Novocaine. Take one ampoule of novocaine, 10 ml of oil plant origin, 10 g honey and one yolk. Apply the resulting composition to wounds in the oral cavity. Carry out events 2-3 times a day.

Decoctions and infusions

To rinse your mouth, you can use the following recipes:

1. Onion peel. Take 40 g of raw materials and 2 glasses of water. Simmer on fire for 15-20 minutes. Add enough water to make 500 ml. Rinse your mouth 3 times a day.
2. Infusion of yarrow. Take 20 g of herb, add 200 ml of boiling water. Leave for 40 minutes. Use the rinse solution. Perform the procedure 4 times a day. The product can be used effectively for stomatitis on the tongue, in the treatment of periodontal disease, gingivitis and other pathologies of the oral cavity.
3. Camomile tea. Take 20 g of herb, pour 200 ml of boiling water. Leave for 40 minutes. Add the missing amount of water and 20 g of honey to the filtered infusion. Use for rinsing 3 times a day.
4. Burdock root and chicory. Take 40 g of burdock root, pour two glasses of boiling water. Simmer on fire for 40 minutes. Place 20 g of chicory in the decoction and wait 1 hour. Use the filtered solution to rinse your mouth after meals.
5. St. John's wort take 20 g of raw material, add 20 g of chamomile, 200 ml of boiling water. Cover the container with a lid and leave for 30 minutes. Filter and use for rinsing.
6. Calendula. Take 20 g of marigolds and 200 ml of boiling water. Leave covered for 1 hour, filter. Use as a mouth rinse for children and adults. You can also use alcohol tincture calendula. Take 10 ml of tincture, 200 ml of warm water. Rinse once a day.
7. Sage. Take 20 g of raw materials, 20 g of calendula, 1.5 cups of boiling water. Simmer on fire for 10 minutes. Cool, filter and use for rinsing. You can prepare an infusion to treat stomatitis in children.
8. Celandine. Wash the fresh grass thoroughly and chop it. For 40 g of raw materials, use 300 ml of warm sea buckthorn oil. Install for 2 days in a dark room. Use for treating mucous membranes with stomatitis. Oak bark. Take 20 g of raw material, add 200 ml of boiling water. Keep the broth covered for 40 minutes. After the broth is filtered, use it for rinsing.
9. Nineforce. Take 20 gm of finely chopped plant roots and pour 200 ml of boiling water. Simmer for 5 minutes and then leave for 4 hours in a warm place. Take 20 g before meals.

Prevention

The development of pathology can be prevented if due attention is paid to prevention. All activities are simple in terms of implementation, but they protect against unpleasant symptoms and long-term treatment.

Careful hygiene

Use dental floss 2 times a day or after meals. This will remove food debris from your mouth and reduce the amount of pathogenic microflora, which irritates the mucous membrane and increases the risk of developing stomatitis. You need to be careful when cleaning between your teeth, otherwise you can scratch your gums, which can lead to the formation of new ulcers.

Aphthous stomatitis is a type of ordinary stomatitis characterized by damage to the oral mucosa. However, with aphthous stomatitis, white islands-ulcers appear in the mouth, with which the gums, palate, inner surface cheeks In some cases, infection in adults also spreads to the tonsils and the surface of the uvula.

This disease is the most severe form of the disease, since in addition to the classic signs of stomatitis, patients suffer from severe pain in the area where aphthae occurs - they feel pain when swallowing, touching the aphthae with the tongue, and while chewing food. Despite the fact that aphthous stomatitis mainly affects children, this disease also affects the oral cavity of adults.

What it is?

Aphthous stomatitis is a type of inflammation of the oral mucosa. The disease got its name because of the symptoms in the form of ulcers (ulcers) in the mouth. These manifestations are very painful and can occur individually or en masse.

Externally, aphthae have an oval, often round shape, with clear pink or red borders. Such wounds can appear on the inside of the lips, tongue, palate, and cheeks. The wounds have different size from 3.5 mm and more.

Causes of the disease

Among the large number of reasons that can cause the appearance and development of aphthous stomatitis, there are various infectious diseases, for example, the herpes virus, some forms of staphylococci, measles, diphtheria, adenovirus, influenza, etc.

Some kind of catalysts and associated factors of this condition are:

• tendency to allergic reactions;
• disorders in the gastrointestinal tract;
• burn of the oral mucosa;
• mechanical damage, for example, from a sharp tooth edge, rough food or when biting the cheek;
• weakened immune forces of the body;
• lack of vitamins, namely B and C, as well as microelements (zinc, selenium, iron, etc.);
• unfavorable heredity;
• pathologies of the oral cavity (pulpitis, dental plaque, caries, etc.).

Very often children suffer from it, and chronic recurrent aphthous stomatitis occurs in adults. In most cases, these are people aged 20 to 40 years.

Symptoms

On different stages development, the symptoms of aphthous stomatitis are not the same (see photo). In the initial period, the disease manifests itself with signs of ARVI:

1. Weakness and malaise occur.
2. Appetite worsens.
3. The temperature rises to 38°C.
4. The cervical and occipital lymph nodes are enlarged.
5. The localization points of herpes in the mouth become red and swollen.

As pathology develops, aphthae form in the oral cavity - small individually located or grouped ulcers with a diameter of up to 5 mm. The edges of the ulcers are distinguished by a reddish tint with a gray coating. External signs aphthous stomatitis are shown in the photo below.

The presence of defects in the mouth creates discomfort while talking, eating, or any movement of the tongue. The patient complains of increased salivation and the inability to fully perceive taste qualities food.

View photos

[collapse]

Subtypes of the disease

Based on the nature of the lesions of the mucous tissue, medicine distinguishes four subtypes of aphthous stomatitis:

What subtype of stomatitis develops in a patient can only be determined by a dentist. Sometimes for this purpose it is necessary to take a smear for analysis in order to determine the causative agent of the infection.

Aphthous stomatitis in children is often confused with the herpes virus. In contrast, aphthous ulcers in their initial stage look like a small red dot, in place of which a vesicle with a grayish-white head and a red rim first forms. When it breaks through, an ulcer forms. Ulcers can be a source of secondary bacterial or fungal infection. As part of general therapy, close attention should be paid to nutrition, excluding acidic foods such as citrus fruits, tomatoes, and apples from the diet.

Treatment of aphthous stomatitis in children and adults consists of a set of measures, including local effects and general therapy, and the choice of certain drugs depends on the severity of the disease.

Diagnostics

Diagnosis is carried out at a dentist's appointment. At visual inspection determined: stage of stomatitis, lesions of the mucous membrane, treatment method. The patient is asked a series of questions - how long ago did the inflammation begin, is there an increase in temperature, etc.

During the examination, the doctor looks at the structure of aphthae, which are in the acute phase and do not heal within 12-15 days. This could be a sign cancer. To ensure the accuracy of the diagnosis, tests are prescribed - blood, biopsy, culture. After receiving the results, treatment is prescribed.

View photos

[collapse]

How to treat aphthous stomatitis?

For local treatment at home, antiseptic rinses and anti-inflammatory gels are prescribed. In adults, medications may vary depending on the type and duration of aphthous stomatitis; an otolaryngologist or dentist will be able to give recommendations on the choice of medications:

• Most often, Miramistin is prescribed in the form of a solution or spray, which is used to irrigate the oral cavity. It has antiseptic properties, fights primarily against the herpes virus, but is nevertheless suitable for normalizing healthy microflora of the oral cavity.
• Anti-inflammatory ointments with an anesthetic effect are often prescribed due to the characteristics of aphthous stomatitis. pain. Among the popular remedies are Kamistad, Clobetasol, Trasylol.
• Also on initial stage use Cholisal-gel. It is applied to the dried affected areas after rinsing. Procedures must be carried out at least four times a day.
• For rinsing in case of predisposition to allergies, use a suspension of Diphenhydramine.
• Also popular anti-inflammatory and analgesic ointments are Xicaine and Benzocaine. Treatment with such ointments should not be long-term, as there are significant side effects. When using them, you must strictly adhere to the course.
• An effective remedy for combating canker sores is Stomatofit-A balm, which consists of medicinal plants and an anesthetic. It is applied with a cotton swab directly to the sores. The action of the drug is aimed at reducing pain and inflammation.
• If signs of secondary infection appear, it is recommended to use antibacterial agents: Hexoral, Tantum Verde, Orasept.
• As soon as the ulcers resolve, it is worth continuing treatment with epithelializing agents that will restore the mucous membrane. Solcoseryl gel is prescribed as such a drug.

What else can you do to help? In case of aphthous stomatitis, it is necessary to adhere to a special diet, the main purpose of which is to reduce irritation of the oral mucosa and nourish the body with a complex of vitamins and nutrients. In this case, doctors recommend adhering to certain rules:

• eat pureed, boiled or stewed food;
• exclude smoked, spicy, salty, sour and fried foods from the diet;
• give up processed foods, fast food and carbonated drinks;
• Regularly monitor oral hygiene, regardless of the state of the disease, and the toothbrush should only be new and with soft bristles.

Also, the causative agent of aphthous stomatitis can be toothpaste, which contains sodium lauryl sulfate, which accompanies the development of the disease. Therefore, when purchasing oral hygiene products, you need to pay attention to this first.

Chronic recurrent aphthous stomatitis

This form of the disease is observed to one degree or another in every fifth inhabitant of the planet. Recurrent aphthous stomatitis is characterized by the appearance of ulcers on the oral mucosa after a sufficiently long period of time. So, for example, with apparent well-being, aphtha occurs after a few months, and sometimes after a few years.

Statistics show that women are more likely to suffer from canker sores than men. Recurrent aphthous stomatitis does not occur on its own - it is preceded by risk factors - trauma to the oral mucosa, allergies to certain foods, poor-quality water, sweet, sour, spicy foods.

Doctors are quite wary of recurrent aphthous stomatitis, since the disease may be a sign of more serious violations in the body - Crohn's disease, anemia, celiac disease, human immunodeficiency virus, malabsorption syndrome, nonspecific ulcerative colitis and others.

Treatment of recurrent aphthous stomatitis should solve three problems for the patient:

• elimination of discomfort and pain;
• accelerating the healing of aphthae;
• prevention of relapse of disease.

Local treatment of recurrent aphthous stomatitis begins with painkillers and anti-inflammatory drugs. To relieve painful sensations, applications with anesthetics are used - a solution of lidocaine, benzydamine hydrochloride, benzocaine. Good effect provides diclofenac solution, amlexonox, tetracycline solution. To suppress the action of inflammatory mediators, triamcinolone acetonide, flucinodide, clobetasol propionate are prescribed. Preparations with these active ingredients Apply to the ulcers several times a day after meals. For large canker sores, cauterization with silver nitrate is possible. At the time of healing of aphthae, vinylin, caratolin, sea ​​buckthorn oil, rosehip oil, Actovegin-gel, solcoseryl.

In case of a protracted course of the disease, when some aphthae have not yet had time to heal, and new ones have already appeared, a course of corticosteroids is prescribed - prednisolone and betamethasone in the dosage specified by the doctor. For epithelialization of severe aphthae, delargin is used ( intramuscular injection). The inclusion of immunomodulators (levamisole, kemantan and others) in therapy is also useful.

View photos

Chronic recurrent aphthous stomatitis

[collapse]

Prevention

Simple measures to prevent the disease:

• regular sanitation of the oral cavity;
• compliance with the rules of oral hygiene;
• balanced diet;
• minimal consumption of food that can cause mechanical or chemical damage to the mucous membrane;
• isolation of the patient from healthy people if stomatitis is contagious;
• avoiding trauma to the oral mucosa;
• exclusion of substances that can cause allergies;
• support immune system adult body with the help of multivitamin complexes.

Aphthous stomatitis is an unpleasant disease that is very painful. It often makes eating difficult due to the formation of ulcers.

Treat this problem traditional methods dangerous and unwise, since stomatitis can become chronic.

There are many types of this disease, so a visit to the doctor cannot be avoided.

What you need to know about the disease

The name of the disease comes from the word “aft”, which means “ulcer”. This type of stomatitis is manifested by damage to the oral mucosa with the formation of ulcers. They can appear separately or be localized in a group, affecting a large area of ​​tissue.

The most common location of aphthae is the front of the mouth, on the inside of the lips and cheeks. This is due to the fact that this area is much more likely to be damaged than others, such as accidental bites or scratches from food.

Less commonly, aphthous stomatitis appears on the tongue. Sometimes the disease is accompanied by weakness and a slight increase in temperature.

The average duration of the disease is 8-10 days.

Aphthae are round or oval erosive areas of skin covered with white or gray coating and surrounded by an inflamed, bright red halo. The size of the aphthae does not exceed a centimeter in diameter.

In the normal course of the disease, one ulcer appears, in in rare cases the number reaches three. When touched, aphthae cause severe pain, so eating is often difficult.

Causes and provoking factors

Experts in the field of studying aphthous stomatitis still cannot come to a consensus on what exactly causes this form of the disease. Various reagents have been identified that are equally capable of causing other forms of stomatitis.

Often the disease occurs due to an infection in the human body or is residual phenomenon viral disease due to a weakened immune system. Popular infections include:

In addition, pathology is often the result of an allergic reaction to food, medications, or microbes that have entered the body. Chronic diseases gastrointestinal tract also contribute to the occurrence of aphthae.

In addition to the main catalysts of the disease, the body must form ideal conditions for the development of stomatitis. These include:

At least one of the described factors can push the reagents to take active action, causing the first symptoms of aphthous stomatitis to appear, requiring treatment at the initial stage.

Classification of the disease

In medicine, there is a division of aphthous stomatitis into two types: acute and chronic:

There is a classification of the disease depending on the nature of the damage to the oral mucosa.

Aphthous stomatitis can be:

The photo shows necrotic aphthae

1. Necrotizing aphthae is an accumulation of dead mucosal cells, which become covered with epithelium during the course of the disease. Most often, this subtype of aphthous stomatitis is found in patients with blood pathologies.
2. granular stomatitis is caused by trauma to the mucous membrane, as a result of which bubbles first appear, then painful ulcers appear in their place.
3. During scarring stomatitis aphthae are covered connective tissue. With intensive treatment, the connection is broken - the tissue is resorbed.
4. Deforming is the most severe form of the presented ones, since aphthae change the surface of the gums. After they heal, noticeable scars will remain.

The degree of damage to the mucous membrane and the type of disease can only be determined by a doctor after analysis. Only on the basis of this data can a comprehensive treatment be prescribed that will effectively cope with the disease.

Main symptoms and duration

The symptoms of the disease directly depend on the form of its course.

Acute form of the disease - everything is unexpected and abrupt

Acute aphthous stomatitis appears unexpectedly. The patient begins to complain of malaise, sometimes a slight increase in temperature is noticeable.

Already at the initial stage, pain is felt in the mouth, which worsens while eating or while talking. Bubbles form on the mucous membrane, quickly developing into erosions, covered with a gray-white coating.

Around the aphthae, the mucous membrane becomes inflamed and becomes loose. You may notice a white coating on the tongue.

As the number of ulcers increases, it becomes difficult to eat solid food; you have to switch to purees and pates.

The duration of this type of disease usually does not exceed two weeks, at the end of which the mucous membrane is restored to its previous state. Very rarely, in the case of a complicated form, minor scars remain.

Chronic form

With chronic aphthous stomatitis, as in the photo on the right, the mucous membrane swells and becomes pale.

Ulcers are located on the inside of the lips, cheeks, and under the tongue. Less commonly, aphthae are localized on the palate and gums.

The size of the lesion reaches a centimeter, the halo swells, becomes red, and a dirty gray coating appears. In the case of extensive necrosis, the ulcers become more inflamed and protrude above the surface.

Chronic aphthous stomatitis usually lasts 12-15 days. If treatment is not started in a timely manner, aphthae will begin to grow deeper, affecting the mucous membrane.

At this stage, the sores will begin to bleed, thereby causing further more pain. In addition, this condition is dangerous due to infection. Deep aphthae may leave scars after healing.

What you need to know about disease therapy

Treatment of aphthous stomatitis should be comprehensive and under the supervision of a doctor. Even after visible signs disappear, you should not stop taking the prescribed medications. This is due to the fact that the disease can return and subsequently develop into a chronic disease.

Local treatment of aphthae

For local treatment in adults, antiseptic rinses and anti-inflammatory gels are prescribed. Drugs may vary depending on the type and duration of the disease; an otolaryngologist or dentist will be able to give recommendations on the choice of drugs:

Antiallergic drugs

Treatment allergic stomatitis, accompanied by the use of antihistamines. These include Diazolin, Claritin, Suprastin, Tavegil.

Others can be used medicines, eliminating allergy symptoms. Typically, the course of treatment with desensitizing drugs lasts 10-12 days.

Sanitation of the oral cavity

Aphthous stomatitis develops against the background of diseases of the gums and teeth, for this reason, during the treatment of ulcers, it is necessary to carry out complete sanitation of the oral cavity.

Eliminating foci of possible erosion on the mucous membrane will reduce the duration of stomatitis, and will also reduce the likelihood of its secondary occurrence.

It is especially important to carry out sanitation of the oral cavity, if this has not been done previously, in case of chronic stomatitis. The presence of tartar, caries, and pulpitis has a beneficial effect on the formation and development of aphthae.

Increasing local immunity

Fermented toothpastes are prescribed as local immunostimulating drugs. They should contain the following substances: lactoperoxidase, lactoferrin, lysozyme or glucose oxidase. These enzymes help increase the resistance of the mucous membrane and destroy bacteria and viruses.

You can buy Imudon lozenges. They are used six times a day, following a course of 10 days.

Good immunomodulators are: ginseng, echinacea, propolis, thymogen, immunofan. Don't forget about vitamins.

The disorder is manifested by severe pain when touching the ulcers. For this reason, preference should be given to liquid and mushy foods.

Pastes, soups, purees, porridges are dishes with which you can create a completely balanced diet. You need to eat right, saturating the body with proteins, fats and carbohydrates, so that the immune system can provide full resistance to the disease.

Cabbage, carrots, potatoes, peaches, parsley, olives, sea ​​buckthorn juice- all these are desirable products that help improve immunity, restore healthy microflora and have an antibacterial effect.

Treatment at home

When the first signs of stomatitis appear, it is necessary to urgently take action using the means that are available in every home. Until a diagnosis is made, it is necessary to maintain hygiene and rinse the mouth frequently. A solution prepared with salt or soda has an antibacterial effect.

It is also good to use a low concentration hydrogen peroxide solution for irrigation. You can dilute a tablespoon in a glass of water and rinse your mouth after each meal.

Often, for the disease, solutions of furatsilin or chlorhexidine are used.

Effectively helps with illness honey water. By adding a tablespoon of honey to a glass of water you can get an antiseptic and antiviral agent, which will stop the development of the disease until a course of treatment is prescribed.

Preventive actions

For prevention purposes, dentists recommend following the principles in everything healthy image life. Excessive use spicy, sweet, sour and salty foods have a negative impact on oral health. Diseases that change the environment in the oral cavity may develop.

If you still cannot change your eating habits, you should not forget about the rules of personal hygiene. Clean hands, caring for the oral cavity is an important component in maintaining health at the proper level.

What can we say about bad habits? It's no secret that they have a detrimental effect on the entire body, starting their negative impact from the oral cavity.

Taking multivitamins, especially during periods of hypovitaminosis, will help increase the body's resistance. Hardening and physical exercise contribute to overall health.

The main rule to avoid aphthous stomatitis is timely treatment infectious diseases that, if left untreated, cause the appearance of aphthae in the oral cavity.

The seriousness of the disease is beyond doubt, so its treatment must be approached comprehensively, based on the recommendations of specialists. By following preventive measures, you can protect yourself from unwanted diseases for a long time.

From this article you will learn:

• how to treat aphthous stomatitis in children,
• symptoms and treatment of aphthous stomatitis in adults,
• list of effective drugs.

Aphthous stomatitis is a disease in which one or more round ulcerations appear on the oral mucosa, which are covered with a necrotic coating of a gray or yellowish tint. Such ulcers (aphthae) are not associated with acute infections and are therefore not contagious.

According to statistics, up to 20% of the population suffers from this form of stomatitis. It most often affects young children, as well as adults aged 20 to 30 years. In people of more mature age, a dependence has been noted: the higher the age, the less likely it is to develop. Aphthous stomatitis has a code according to ICD 10 - K12.0.

Aphthous stomatitis in children: photo

Aphthous stomatitis: photos in adults

The most important thing in treating stomatitis is to first correctly determine its form. Indeed, depending on the form: it can be either or aphthous stomatitis - treatment for both adults and children will be completely different. Therefore, if you are not very sure of the diagnosis, it is best to familiarize yourself with the symptoms of both of its forms.

Aphthous stomatitis: symptoms

If you suspect you have aphthous stomatitis, the symptoms are quite similar. A day or two before the onset of ulcers, patients usually notice a slight burning sensation in some areas of the oral mucosa. A little later, one or 2-3 clearly defined ulcers (aphthae) appear, covered with a necrotic coating of a gray or yellowish tint. The ulcers are round in shape and their diameter is usually no more than 1 cm, and along the perimeter they are surrounded by an inflammatory red halo.

Ulcers of this size usually heal within 10 to 14 days without scarring. However, in 10-15% of patients, the diameter of the ulcers may exceed 1 cm, and sometimes they can even reach 2-3 cm in diameter. Ulcers of this size are usually deeper than ulcers smaller than 1 cm (which may cause the ulcer border to appear raised). Healing of such ulcers usually lasts up to 6 weeks, and most often with the formation of scar tissue.

Important : Typical localization of ulcers is on the mucous membrane of the cheeks and the inside of the lips, on the soft palate (Fig. 7-8), tonsils, as well as the lower and lateral surfaces of the tongue. This localization is due to the fact that ulcers in aphthous stomatitis occur primarily on “non-keratinized” areas of the oral mucosa, i.e. where keratinization of the mucosal epithelium does not occur.

Less commonly, ulcers can occur on the keratinized mucous membrane (hard palate, dorsum of the tongue, tightly attached alveolar gum around the teeth) - this may be a signal of autoimmune diseases or HIV infection. Unlike aphthous stomatitis, keratinized gums are affected precisely by herpetic stomatitis, which may also be a distinguishing feature of these two main forms of stomatitis from each other.

Foci of aphthous stomatitis on the soft palate: photo

Causes of aphthous stomatitis -

The reasons for the development of aphthous stomatitis are not fully understood. However, the very mechanism of the appearance of ulcers on the mucous membrane is most often associated with the activation of the cellular immune system - T-lymphocytes, neutrophils and mast cells. It is these cells of the immune system that suddenly begin to destroy the epithelium of the mucous membrane, leading to the appearance of ulcerations. However, the system humoral immunity(antibodies) – may also be involved in this process.

Antibodies can begin to destroy the oral mucosa, for example, through so-called cross-sensitization. The fact is that such a pathogenic oral bacterium as α-hemolytic streptococcus Streptococcus sangui can act as an antigen that provokes the production of antibodies by the immune system. And these antibodies cross-react with the oral mucosa, locally destroying it.

Local triggering factors –

• allergies or increased sensitivity To various components hygiene products (especially often sodium lauryl sulfate)*,
• food allergens,
• some pathogenic bacteria(hemolytic streptococcus),
• biting the mucous membrane of the lips and cheeks due to stress,
• trauma to the mucous membrane due to the overhanging edge of the filling or during anesthetic injection,
• excess nitrate content in food and drinking water.

Important : a clinical study that revealed the effect of sodium lauryl sulfate, found in many toothpastes, on the development of aphthous stomatitis - published in the medical journal “Oral Diseases” (Jurge S, Kuffer R, Scully C, Porter SR. 2006).

Systemic diseases and conditions of the body –

• during menstruation in women,
• in case of abrupt cessation of smoking,
• for celiac disease, enteropathy, malabsorption,
• for hematological diseases,
• diseases of the immune system,
• with a lack of folic acid, vitamins B6 and B12,
• against the background of cyclic neutropenia, Behcet's syndrome, Reiter's syndrome, PFAPA syndrome (periodic fever, aphthous pharyngitis + cervical adenopathy), systemic lupus erythematosus, reactive arthritis, inflammatory diseases intestines - especially with Crohn's disease, as well as against the background of HIV.

What is the diagnosis based on?

The diagnosis of aphthous stomatitis is made based on visual examination, and in most cases does not require any laboratory tests. Only when severe forms In cases of chronic or persistent (recurrent) aphthous stomatitis, a complete blood count must be performed, which may indicate the presence of neutropenia or iron deficiency anemia.

As we said above, enteropathy may be the cause in about 5% of cases, and it can be diagnosed by detecting endomysial antibodies in the blood serum. Behcet's syndrome can be suspected if inflammation occurs simultaneously choroid eye (uveitis).

Testing for HIV is always required if stomatitis recurs often or is severe, and especially if ulcers occur not only in areas of the mobile mucous membrane of the oral cavity, but also in areas of keratinized mucosa (for example, on tightly attached alveolar gums near the teeth , back of the tongue, hard palate).

Aphthous stomatitis in children: treatment

Aphthous stomatitis in adults is the same as canker sores in children - the treatment is the same, and the treatment strategy described below is suitable for patients of any age. Concerning medicines listed later in the article, some of them actually have age restrictions, which we will also indicate.

Due to the fact that it is usually impossible to clearly identify the specific cause of aphthous stomatitis in a particular patient, treatment will be multifocal, i.e. drugs of several groups are used simultaneously. The choice of treatment strategy and medications will depend on the following 3 factors:

1) on the severity of symptoms,
2) on the frequency of relapses,
3) from identified predisposing factors.

Treatment at the first stage should be aimed at reducing pain and inflammation in the area of ​​ulcers, and at the second and third stages - at speedy epithelization of ulcers and preventing their occurrence in the future. To facilitate the choice of the best treatment option, all patients can be divided into 3 types (according to the criteria - severity of the disease and frequency of relapses).

• Type A –
  In patients of this type, aphthous stomatitis occurs no more than several times a year and is characterized by slight pain. First of all, in such patients it is necessary to identify local predisposing factors and eliminate them (for example, overhanging edges of fillings or hygiene products with sodium lauryl sulfate). It is important to ask the patient about eating habits to evaluate a possible relationship between stomatitis outbreaks and certain foods.

  The patient is advised to avoid solid foods (eg, crackers, toast), all types of nuts, chocolate, eggs, acidic drinks or foods - fruit or citrus juices, tomatoes, pineapples, salty foods. Should be avoided spicy food, any spices, including pepper and curry, as well as alcoholic and carbonated drinks. In type A patients, local symptomatic therapy is mainly used, which includes antiseptic rinses and gel applications for pain and inflammation.

• Type B –
  in such patients aphthous form stomatitis develops almost monthly, and the ulcers are so painful that they force the patient to change habits (for example, brushing teeth less often due to severe pain). It remains important to identify local and general predisposing factors and, if possible, eliminate them. It is very important to teach patients of this type to feel the first signs of the imminent appearance of ulcers - burning, itching or swelling of the mucous membrane, in order to ensure early local treatment even before the formation of the ulcers themselves.

• Type C –
  in patients of this type, ulcers have very severe pain, appear so often that while some lesions are healing, the next ones appear almost immediately. This group also includes patients in whom local treatment in the oral cavity is completely ineffective, and improvement in their condition occurs only after the use of systemic therapy.

Local therapy: list of drugs

Below you will receive comprehensive information on how to treat aphthous stomatitis in children and adults. Please note that local oral therapy is basic and has good results in type A patients, somewhat less well in type B patients.

1) Antiseptic rinses –

In young children (who cannot yet rinse their mouths) - this is best used in the form of a spray. For older children, the best option would be a 0.05% chlorhexidine solution. The best option for adults - this is a “Perio-Aid” rinse containing two antiseptics at once: chlorhexidine 0.12% and cetylpyridine 0.05% (or a simpler option - again the usual 0.05% chlorhexidine for 25 rubles).

As an alternative to traditional antiseptic rinses, it can be used in the form of a solution or spray. This medicine contains a large number of anti-inflammatory components (medicinal plant extracts, thymol, allantoin, phenyl salicylate), but antiseptic effect the drug will be quite moderate. One more effective option There will be triclosan rinses from Colgate.

How to use –
rinsing is carried out 2-3 times a day for 1 minute. They should be carried out immediately after oral hygiene. And after rinsing, you can apply an anti-inflammatory gel to the oral mucosa (in areas of ulceration).

2) Anti-inflammatory/pain-relieving gels –

The best option for adults and children - this is the drug Cholisal based on the anti-inflammatory components choline salicylate and cetalkonium chloride, which have a pronounced anti-inflammatory and analgesic effect. In addition to its effectiveness, the big advantage of this drug is the complete absence of age restrictions.

To relieve pain from ulcers in adults and children over 12 years of age, you can use the drug Kamistad, containing 2% lidocaine hydrochloride, chamomile extract and the antiseptic benzalkonium chloride. And for young children - the drug “Kamistad Baby” based on an extract of chamomile flowers and the analgesic component polidocanol. But their effectiveness in aphthous stomatitis will certainly be lower than that of Cholisal.

Important : the best drug The prescription drug Amlexanox is used to treat canker sores. tradename– Aphthasol). This drug is available in the form of a paste for application to the surface of ulcers 4 times a day, and has anti-inflammatory, antiallergic and immunomodulatory effects. Unfortunately, it is not sold in Russia and can only be purchased by prescription in Europe or the USA.

3) Occlusive agents –

These include products, for example, based on bismuth subsalicylate. Drugs in this series are classified as gastroprotectors, and are usually prescribed for gastric ulcers and duodenum. However, their local use in the oral cavity for aphthous stomatitis makes sense and can significantly reduce pain and speed up recovery.

The point of using these drugs is that when applied to the surface of ulcers, they form an insoluble protective film that protects the surface of the ulcer from irritants and reduces the local inflammatory process (site). What preparations based on bismuth subsalicylate can be used - in the form of chewable tablets, in the form of a gel/suspension. These medications should only be used after preliminary application antiseptic rinse and/or anti-inflammatory gel.

4) Local application of glucocorticoids –

If aphthous stomatitis develops against the background of diagnosed immune diseases, then treatment can be carried out with glucocorticoids. Treatment with glucocorticoids is also indicated if the patient does not respond to treatment with traditional local remedies (see above). The purpose of their use is to eliminate severe pain and inflammation, which will allow the patient to eat, speak normally, and perform normal oral hygiene. In addition, glucocorticoids reduce the healing time of ulcers.

Most often, triamcinolone acetonide, fluocinolone acetonide or clobetasol propionate are used for this (the choice depends on the severity of the lesions). These three drugs can be used in gel form when ulcerative lesions are localized in nature, or prepare solutions for rinsing using solutions of these drugs in ampoules, if the lesions are very numerous. Another option for local use of glucocorticoids is a single local injection of triamcinolone solution at the base of each ulcer.

5) Epithelizing agents –

As we said above, at the first stage of treatment of aphthous stomatitis, it is very important to use antiseptic rinses, special gels for pain and inflammation, protective agents based on bismuth subsalicylate (as well as oral antihistamines). But when acute symptoms passed - it is very important to accelerate the epithelization of the surface of the ulcers. For these purposes, the drug Solcoseryl in gel form can be used.

This gel not only accelerates the epithelization of the surface of ulcers and erosions, but also has a sufficient analgesic effect. The gel can be used 2-3 times a day. Read the instructions for use below. Once again, we draw your attention to the fact that this drug is not intended for use in the acute phase of ulcer formation; usually, its use can be started from the 5th day of complex therapy.

6) Local application of laser –

Clinical studies have found that the use of the 940 nm diode laser, as well as the Nd:YAG laser, provides immediate pain relief and faster healing, and is well tolerated by patients. Most patients note that ulcerative lesions heal much faster after laser treatment (about 4 days) - versus 7-14 days after standard drug therapy.

In addition, patients noted that relapses of aphthous stomatitis after laser treatment occur much less frequently. Below you can see a photo of foci of aphthous stomatitis on the tongue and lip before and after their treatment with a 940-nm diode laser.

Laser treatment of aphthous stomatitis: before and after photos

Systemic pharmacological treatment –

Systemic therapy includes 3 types of drugs - antihistamines, glucocorticoids and immunomodulators. Antihistamines can be prescribed to absolutely all patients with aphthous stomatitis, the cause of which has not been precisely established. As for the drugs of the other two groups, they are the second line of defense, after which there are essentially no other treatment options.

1. Antihistamines –

Due to the fact that in many cases the causes of aphthous stomatitis may be unidentified food allergens (or components of hygiene products, such as sodium lauryl sulfate), it makes sense to start taking antihistamines, i.e. antiallergic drugs. It is advisable to use drugs of the latest generation that have a high tropism for receptors, i.e. Please do not use any diazolin. The course of application is usually 7-10 days.

Modern antihistamines are well tolerated and do not have significant side effects, therefore, given the difficulty of identifying the real reason the appearance of ulcerations, you can start taking them from the first day of the disease, or even better - in the prodromal period, when ulcers have not yet formed, but the patient can already feel a slight burning or itching at the site of their future occurrence.

In general, antihistamines are an excellent addition to topical therapy for even mild cases of canker sores. Ideally, of course, take allergy tests for the main types of allergens. To do this, you will need to visit an allergist, and this must be done before you start taking antihistamines.

2. Systemic glucocorticoids –

These drugs are the second line of defense and are a lifesaver for patients with acute severe outbreaks of aphthous stomatitis. Typically, prednisolone tablets are used in adults at an initial dose of 25 mg/day for the first 7 days (followed by a gradual dose reduction). The total duration of therapy is usually 15 days, but in severe cases can reach 1-2 months.

However, in a clinical study by Pakfetrat et al. – good results of treatment with prednisolone were achieved when used at a dosage of only 5 mg/day. Prednisolone is extremely effective drug for the treatment of severe forms of aphthous stomatitis, but its dosage must be selected individually for each patient, taking into account the severity and severity of the disease, as well as the patient’s health condition. Please note that prednisolone may cause long-term side effects.

Search for alternative more safe drugs allowed us to find that the drug Montelukast (a leukotriene receptor antagonist used as an anti-asthmatic drug) - at a dose of 10 mg per day, like prednisolone, reduced the number of lesions, relieved pain and accelerated the healing of ulcers, and at the same time caused significantly fewer side effects (clinical study - Femiano et al.). It is important that Montelukast can be used even when systemic glucocorticoids are contraindicated.

3. Immunomodulators –

Immunomodulators are also a second line of defense, as are glucocorticoids. Their use is especially indicated in patients who are diagnosed with chronic recurrent aphthous stomatitis (with frequent relapses and an aggressive course of the disease). Among the immunomodulators, amlexann, colchicine 1-2 mg/day, cyclosporine, cyclophosphamide, dapsone, methotrexate, montelukast, and thalidomide at a dose of 50-100 mg/day can be used.

When using thalidomide, 85% of patients experience complete remission of severe lesions within the first 14 days, but this drug has very strong side effects. Another immunomodulator is the drug Levamisole, which restores normal phagocytic activity among macrophages and neutrophils and modulates T-lymphocyte-mediated immunity. The use of levamisole significantly reduces the duration of outbreaks of aphthous stomatitis, and it is prescribed - 150 mg 3 times a week (for 6 months).

Levamisole is safer than other immunosuppressive drugs, although side effects including nausea, hyperosmia, dysgesia and agranulocytosis have also been reported. It should be noted that treatment with immunomodulators and glucocorticoids is essentially palliative, because neither of systemic drugs still cannot provide permanent remission of the disease.

As soon as you notice the appearance of ulcers due to aphthous stomatitis, immediately start taking an antihistamine (anti-allergy) drug, plus eliminate from your diet all the foods and drinks that we described above. Get started right away local therapy, which includes an antiseptic rinse, an anti-inflammatory gel + a product based on bismuth subsalicylate to protect the surface of ulcers from irritants. See if your toothpaste contains sodium lauryl sulfate, and if so, it's worth purchasing toothpaste without this component.

If brushing your teeth causes pain, then buy a soft toothbrush (they are usually used for inflammation and bleeding gums). For adults and children with constantly recurring outbreaks of aphthous stomatitis, there is an excellent preventive remedy - and a whole complex of lactic enzymes. These components increase protective factors oral mucosa, preventing the development of new cases of aphthous stomatitis. The Splat company has such toothpastes.

Additional laboratory research –
with frequent, recurring outbreaks, a complete blood count is necessary to rule out hematological diseases. It is important to check blood plasma immunoglobulins and the number of lymphocytes, and take a test for HIV infection. To exclude autoimmune diseases, the patient is usually referred for the following tests - erythrocyte sedimentation rate, antinuclear antibodies and antineutrophil cytoplasmic antibodies, IgA-antiendomysial antibodies, plus antibodies to tissue transglutaminase.

If ulcerative lesions heal very poorly, take a long time and practically do not respond to local treatment, it is necessary to refer the patient for a biopsy to exclude granulomatous conditions such as orofacial granulomatosis, tuberculosis or malignant tumors.

Very important -

If your child has stomatitis, it is very important to correctly determine its shape. Usually it is either aphthous or, and the most important thing is that they are treated completely differently. If your child develops stomatitis, you should not call the pediatrician. These specialists usually don’t even know that there are several forms of stomatitis, and they still either treat them with brown, blue and metrogil, or prescribe a whole bunch of drugs with opposite effects - as if for everything at once.

It makes sense to contact a pediatrician only if the child’s general condition is serious (high temperature, etc.), but such symptoms are characteristic not of aphthous stomatitis, but of herpetic stomatitis. Therefore, it is best to contact pediatric dentist, and at the reception of the children's dental clinic you can always make a house call. We hope that our review: Aphthous stomatitis treatment in adults and children was useful to you!

Stomatitis is an inflammation of the oral mucosa, which is accompanied by the formation of small aphthae like ulcers on its surface. The principle of treatment for aphthous stomatitis depends on the cause of its occurrence, the age of the patient, the severity of the disease and requires mandatory medical intervention.

Causes of aphthous stomatitis

Aphthous ulcers on the oral mucosa look like white spots with a red rim. Such formations can be round or oval. Ulcerations occur singly or in large patches. Most often, the inflammatory process affects the front part of the mouth: the inside of the cheeks and lips. This is due to the fact that it is this area of ​​the oral cavity that is most susceptible to damage: bites while eating and scratches. Less commonly, the location of afts is the mucous membrane of the tongue.

The average period of the disease is 8–10 days. Typically, aphthae heal quickly without leaving scars.

Experts call the following causes of aphthous stomatitis:

• Low immunity. According to doctors, this is the main reason for the development of the disease. Aphthae inside the mouth form in people who often suffer from colds and viral diseases against the background of reduced immunity.
• The disease often occurs with complicated tonsillitis, pharyngitis, and gastrointestinal diseases.
• Insufficient oral hygiene.
• Sometimes the cause of aphthous stomatitis is the penetration into the body of pathogenic microorganisms such as L-form staphylococci, herpes viruses, measles, adenoviruses, and diphtheria bacillus.
• Inflammation of the mucous membrane can result from an allergic reaction of the body to certain foods or medications.

Provoking factors for the development of the inflammatory process are also: hypothermia of the body, hereditary predisposition to disease, vitamin deficiency, diseases of teeth and gums. One or several unfavorable factors can provoke the formation of aphthous ulcerations.

Types of aphthous stomatitis

In children, aphthous stomatitis is much less common than in adults. This is primarily due to the lack serious pathologies digestive system, best condition teeth and body. In adults, with constant disruptions in the functioning of the immune system, the acute form of the disease becomes chronic.

The description of these two forms in dentistry looks like this:

• Acute gingivostomatitis. Acute aphthous stomatitis develops against the background of diseases of viral origin. It usually affects children under three years of age after they have had diphtheria, measles, rubella, and whooping cough.
• Recurrent chronic aphthous stomatitis. The reasons for the transition of the inflammatory process into a chronic form are staphylococci, viruses, impaired immunity and allergies. Constant relapses are also observed in people with gastrointestinal diseases or those who have a genetic predisposition to oral inflammation.

There is another classification of the disease: according to the nature and severity of damage to the mucous membrane. In addition to acute and chronic aphthous stomatitis, dentistry distinguishes the following types of this pathology:

Each of these types of aphthous stomatitis has its own characteristic symptoms.

Symptoms of aphthous stomatitis

Symptoms of aphthous stomatitis largely depend on the type and form of the disease. If the disease is mild, it is not always possible to notice symptoms at the initial stage. Sometimes it is so insignificant that patients do not attach any importance to it. During the entire period of illness, only 1 aphtha may form in the mouth. But more often the inflammatory process gives a person a lot of painful and uncomfortable sensations.

Acute aphthous stomatitis begins suddenly and is characterized by pronounced symptoms. First, the patient complains of a general malaise typical of colds and viral diseases, a slight increase in temperature may soon occur.

The acute form of aphthous stomatitis is also manifested by the following symptoms:

• severe headaches;
• enlarged lymph nodes that are painful on palpation;
• temperature rise to 38 °C;
• foul breath due to ulcers;
• bowel dysfunction: constipation is replaced by diarrhea.

With the development of herpetic aphthous stomatitis, a slightly different clinical picture is observed:

• strong fever (this is how the disease manifests itself in small children and infants);
• pronounced pain, due to which the child is constantly capricious;
• disturbance of night sleep due to poor health;
• decreased appetite, the child may refuse to eat for several days.

When chronic recurrent aphthous stomatitis develops, the following symptoms occur:

• insomnia or drowsiness;
• irritability;
• loss of appetite;
• increased salivation;
• swollen lymph nodes;
• attacks of vomiting (in children);
• formation of irritation in the corners of the mouth.

In any form of the disease, a person feels pain while eating. When visually examining the tongue, you may notice a white coating on it, and blisters or ulcers on the inside of the cheeks and lips.

Treatment of aphthous stomatitis

Treatment of aphthous stomatitis depends on the form of its course. If the inflammatory process is viral in origin, therapy is carried out at home. It is based on following a gentle diet with the exception of spicy, salty, sour and solid foods, which irritate the already inflamed mucous membranes.

Mechanical removal of tartar

Mandatory action in the treatment of aphthous stomatitis, regardless of its form, is the removal of plaque and tartar. These deposits may contain a large number of pathogenic agents, which became the cause of the development of pathology. The absence of such action on the part of a specialist is the main reason why a patient cannot be cured of stomatitis.

To treat areas of inflammation, dentists recommend lubricating ulcers. boric acid, hydrogen peroxide or rinse your mouth with chamomile decoction. If there are ulcers in the throat, gargling with these products is also recommended.

For cupping pain syndrome apply:

• Lidochlor.
• Hexoral.
• Anestezin.

Patients with a predisposition to allergies are prescribed a Diphenhydramine suspension to rinse the mouth and throat.

To cure chronic recurrent stomatitis, you need to rinse the mouth with Chlorhexidine and treat the ulcers with local glucocorticosteroids. For this purpose, dentistry uses:

• Clobetasol ointment;
• Fluocinonide ointment;
• Dexamethasone solution for rinsing.

Dentists often prescribe anti-inflammatory drugs with an anesthetic effect to patients: Kamistad, Clobetasol, Trasylol, Xicaine and Benzocaine. You cannot do without them if severe pain occurs, but long-term use These medications are unacceptable, as adverse reactions are possible.

If signs of aphthous stomatitis reoccur, the use of local medications becomes advisable. antibacterial action: Tantum Verde, Orasept. In the fight against canker sores, regardless of their origin, Stomatofit-A balm has proven itself well. The medicine consists of medicinal extracts and an anesthetic. It must be applied with a cotton swab to the localization of aphthae.

When the ulcers have healed, it is necessary to continue treatment with epithelializing drugs that will restore the mucous membrane. Among such products, Solcoseryl gel is actively used in dentistry.

Allergic stomatitis must be treated with oral antihistamines. Local ointments, solutions and suspensions with an anti-inflammatory effect are also used. To rinse the mouth and throat, decoctions of oak bark, chamomile, sage, calendula and other soothing herbs are used.

How to treat aphthous stomatitis in children

Treatment of childhood aphthous stomatitis has its own characteristics. Whenever characteristic symptoms You should visit your pediatrician and dentist's office. A mandatory action should be to follow a gentle diet, which will prevent irritation of the already inflamed mucous membrane.

Children are prescribed antihistamines to relieve swelling and reduce an allergic reaction:

• Cetrin.
• Diazolin.
• Claritin.
• Telfast.
• Zodak.
• Suprastin.

Immediately after elimination severe inflammation When the acute phase subsides, Actovegin-gel is included in the course of treatment of aphthous stomatitis in children. The action of this drug is aimed at accelerating the regeneration process damaged cells, wound healing and mucosal restoration.

Treatment is not complete without immunomodulators. From this group of drugs, children are prescribed the use of toothpaste with lysozyme, glucose oxidase, and lactoferrin. Enzymes have a beneficial effect on the affected mucous membrane, increasing its resistance against viruses and bacteria.

The treatment tactics should be prescribed by a specialist; self-medication of aphthous stomatitis can cause serious complications.

Considering that the patient may experience a worsening of the condition when eating irritating foods, it is important to adhere to a gentle diet. It is built on the following rules:

1. The diet should consist of finely chopped and pureed food.
2. All products must be heat-treated; before use, they must be boiled or doused with boiling water.
3. You cannot eat hot or cold food; food should be at room temperature.
4. Every time after eating, you need to rinse your mouth with water or a decoction of herbs to remove any remaining food.
5. If the aphthous ulcers are so inflamed that eating is uncomfortable, you should use a wide straw while eating.

To prevent the occurrence of the disease, it is recommended to regularly visit the dentist’s office, monitor oral hygiene, and promptly treat diseases that can lead to a decrease in immunity.